by Amy Ruttan
“Sure.” Derek went to the front desk and relayed the instructions to Janet, who went straight to work.
Nancy the receptionist had locked the front door and closed the blinds.
“All your patients and Dr. Saunders’ patients have been rescheduled,” Nancy said. “I’ll man the phones. And I’m still trying to get hold of Christina’s husband in the logging camp.”
“Thanks, Nancy. How about that air ambulance?”
“It’ll be ready in thirty minutes, but there’s a storm brewing off the coast.”
Great.
Derek scrubbed a hand over his face. “Keep them on standby, okay?”
Nancy nodded. “Will do, Dr. Taylor.”
Derek turned to Evelyn, who had come out of the exam room.
“Well?” he asked.
“The baby is breech. Frank breech. The baby should’ve been turned last week.”
Derek cursed under his breath. “What do we do?”
Evelyn bit her lip. “Her contractions are strong. Janet is getting a read-out, and it doesn’t appear that the baby is in distress. It’s just happening so fast.”
“So taking them in an air ambulance to Sitka is out of the question?”
“Yeah, that baby is going to move soon, if the contractions and her dilation progress have any say in the matter. As it’s a frank breech I may be able to deliver the child vaginally. But it’ll be hard and she’ll have to work...”
“Your other option?” Although Derek already knew, and it terrified him to the core.
“You have surgical equipment. I’ve seen it. And I have taken courses in anesthesiology.”
“So have I,” Derek said. “Do you think it will come to that?”
“I don’t know.” Evelyn tied her hair back. “Do you have any spare scrubs in the back?”
“Yes. What do you need me to do?”
“Prep surgical supplies, just in case, but I’m hoping that it doesn’t result in a crash C-section. Janet has the patient’s care in hand. You didn’t tell me she was a nurse who had skill in midwifery.”
“Well, we never got around to that.” Derek took a deep breath. “I’ll help any way I can.”
Evelyn nodded. “I appreciate it. I’ve delivered frank breech babies before. It can be done. Protocols have changed. It’s not an automatic C-section.”
Derek nodded. “I know.”
“Good, because it looks like there’s going to be a baby born. Today.” Evelyn headed off to the storage room to change into scrubs.
He went to collect the surgical supplies, his insides twisting, and tried to shake away all those dark memories that were threatening to bubble up.
There’s a supply of blood in the fridge. You’re prepared this time.
He had this. This was his patient. He had control. He was prepared for anything.
Vivian’s death had taught him to be prepared so more lives could be saved and fewer lives lost. Vivian’s death was the reason why he fought so hard for a hospital in Wolf’s Harbor. And it wasn’t just for crash C-sections, but other traumatic injuries. They needed more room. They needed surgeons here. Qualified people.
But no one ever stayed.
Except him.
And Evelyn?
She could handle it. She was trained for this and he was glad she was here. They were the only hope and he had to pull himself together. There was no time to think about Vivian. Right now he had to help Evelyn save two lives. They needed to be a team and he needed his A-game. Which was exactly what he’d give.
CHAPTER FOUR
DEREK JUMPED INTO the fray and seemed to anticipate her every move. It was nice. It could take time for two doctors to learn each other’s cues and timings and work seamlessly together, but with Derek it was as if they had been working together for years.
And that put her at ease about delivering a frank breech baby on her first day back in Wolf’s Harbor.
The receptionist, Nancy, helped her into a gown and gloves.
“She’s ten centimeters dilated, Dr. Saunders, and her water broke,” said Janet. and showed Evelyn the read-out. The baby’s heartbeat was strong and everything was going smoothly—except the fact that the baby was heading out upside down. “The contractions are close and strong.”
Evelyn nodded. “Thank you, Janet. Christina, I think we’re ready to have this baby.”
“Tom isn’t here,” Christina panted. “I can’t have this baby without Tom!”
“I don’t think the baby is going to wait for Tom,” Evelyn said as she took a seat at the end of the bed. She bent down and could see the baby’s backside crowning. “In fact I know we can’t wait for Tom. You’re going to have push and push hard, Christina. This baby is breech. But we’ll be with you all the way and at the end you’ll have your baby, yes?”
Christina nodded, but she was crying.
Derek stepped up and held Christina’s shoulders. “I’m here in Tom’s place, okay? I’m here for you, and you know I’ve done this before.”
Christina nodded, and Evelyn couldn’t help but melt slightly, watching the care and tenderness Derek showed his patient. The gruff exterior was gone and replaced by something tender and compassionate.
It made her heart skip a beat.
She shrugged it off and watched the monitor as another contraction went off. “Come on—now, push, Christina. Hard. That’s it. Push to ten.”
Evelyn kept one eye on the monitors and one eye on the baby. Twenty years ago she’d have been putting Christina under and delivering the baby via C-section, but a frank breech—if the mother and baby were healthy—could be delivered the old-fashioned way. If the baby had been a footling breech it would be a different story.
Still, this was going to be a hard birth.
Janet continued encouraging Christina, and Derek supported their patient as Evelyn guided a beautiful baby girl into the world—bum first.
The baby didn’t cry right away, but that wasn’t unusual, and Evelyn suctioned the mouth while Janet rubbed the baby vigorously.
There was a fraction of a moment when Evelyn worried, just for a second, that the baby wouldn’t cry and she’d have to resuscitate. She shifted her brain to focus on the protocol for that—especially since they weren’t in a hospital. But it was only for a fleeting moment, because then the baby took a breath and cried out at the indignity of being cold and pestered.
Evelyn’s heart swelled and she smiled behind her surgical mask. This was her favorite part. Life. A healthy baby. She held the little one carefully to get a closer look. Her heart raced as a secret pang of longing coursed through her.
So wonderful. Pure. A new life safely arrived in the world.
The possibilities for this baby were endless. It was thrilling, as always, to be there on day one of a child’s life.
“It’s a girl!” she announced. “Do you want me to cut the cord?”
Christina nodded. “Tom was going to do it...but, yeah.”
Evelyn cut the cord and the placenta was delivered soon after. Janet took the baby to the warmer to rub ointment in her eyes, weigh her and do the heel stick. Everything that needed to be done. But it wasn’t long before the baby was brought back to Christina, to be held skin to skin with the relieved mother.
“Excellent work, Dr. Saunders,” Derek said as Evelyn finished cleaning up. He was beaming at her. Those intense eyes sparkling with pride. “Seriously—excellent job.”
“Thanks to you, as well,” she said. “I couldn’t have done that without you.”
He looked stunned. “I did nothing.”
“What do you mean nothing? You have a well-stocked clinic and I didn’t have to give you instructions. You knew what to do.”
“Still, you did all the work,” he whispered.
“I don’t do much,” Evelyn said. “I just catch th
em.”
Derek chuckled and then left the room.
Evelyn passed on the post-op care to Janet. If all went well Christina and the baby could go home today. For a breech birth, it had been almost textbook. And she was relieved that the first birth she’d had to attend to in Wolf’s Harbor had been easy.
As she peeled off her gown and gloves Nancy opened the door to the exam room. “Look who I found!” she announced.
A man in flannel and denim, who looked a bit wide-eyed and dazed, stumbled in. “Did I miss it?”
“Tom, I presume?” Evelyn asked with a smile.
“Yeah. I missed it, didn’t I?” He rubbed his hand over his head. “I knew I shouldn’t have gone to work today.”
“Everything is fine, Tom. Go meet your daughter.”
Tom grinned. “A girl?”
Evelyn watched as Tom went to Christina and bent down to see his newborn daughter. A happy family.
That pang of longing for something she could never have washed over her again.
But you could have it if you want.
She forced that thought away and left the exam room to clean up. The birth had happened so fast. It was only lunch time and they could see their patients in the afternoon. She could still get Jennifer Yazzie in.
Evelyn went to find her file, worried suddenly, because if Dr. Pearson hadn’t tried to turn Christina’s baby before he left, what was going on with Jennifer and her small measurements?
Nancy was back at the front desk.
“Can you reschedule Jennifer Yazzie for later this afternoon, Nancy?”
“Sure, Dr. Saunders.”
Evelyn thanked Nancy and headed to exam room three, which had a desk and was obviously the office for a rotating specialist. It was cramped, and a bit dark, but it worked and that was where she set up her computer.
There weren’t many pregnant women in Wolf’s Harbor, but there were a couple of six-week check-ups and everyday women’s health stuff to deal with. For the most part it was going to be an easy job.
Evelyn fired up her laptop and frowned because the clinic did not appear to have high-speed internet access.
“Have I gone back to the time of dial-up?” she murmured under her breath.
“Yeah, the Wi-Fi here is really not reliable.”
Evelyn looked up and saw Derek standing in the doorway. Her cheeks flushed with warmth at being caught muttering to herself.
“It’s okay,” she said.
“It’s just a fact of life at the clinic and in these parts. Life can move a bit slower around here.”
“Not for Christina,” Evelyn teased. “Thank you again for your help.”
Derek nodded. “Like I said, I didn’t do anything. You did fantastic, though. You really calmed her down.”
“Thanks. Textbook frank breech birth, though. Nothing to it.”
She turned back to her computer, embarrassed by the compliment. She knew that she was good—one of the best—but it was always hard for her to take praise when she was just doing her job.
“I was going to head to Sally’s next door and grab a quick bite. Do you want to join me?”
The question caught Evelyn off guard. “No, thank you. I want to look up some information, and I have a quick email I want to send to a colleague before I see Jennifer Yazzie this afternoon.”
“Anything I can help with?”
“Did the other OB/GYNs confide in you about their patients?”
“No. Not really. They didn’t like to talk to a general practitioner who knows nothing.”
Evelyn rolled her eyes. “Why does that not surprise me?”
Derek shrugged. “You get used to it. Still, it angered me. The people in Wolf’s Harbor are my patients long after any temporary specialist is gone.” He crossed his arms. “When I came to town fifteen years ago Jennifer was my first patient. She was five years old. I know her medical history pretty well.”
“You’ve been here a long time.”
“I like it here. This is home.”
“It must be weird, seeing your patients having families of their own. Makes you feel a bit old, doesn’t it?”
“Well...now it does.”
Then Derek smiled, which totally caught her off guard, and she couldn’t help but laugh with him.
“So you’re not opposed to talking over stuff with me?” he asked.
“No. I work better sometimes after talking it out.”
“Not surprising. I’m the same. Fire away.”
“It’s about Jennifer Yazzie.”
“What’s eating you about Jennifer?”
“I met her when I arrived, and she told me how far along she is, but she’s awfully small.”
Derek’s brow furrowed. “What’re you thinking?”
“Anything in her past I should know about? Beyond the obstetrical records?”
“No. She’s been healthy. Non-smoker and non-drinker. Are you thinking it’s intrauterine growth restriction accounting for her small measurements?”
She was impressed that his mind had immediately gone there.
“I’m hoping it’s not, but I’m worried about that. We’d have to get her to Juneau—to a larger hospital to deliver the baby. But I’m hoping she’s just carrying small. Some women will do that right until the baby is about to be born. But if not, it could be very dangerous for Jennifer and her baby.”
A strange expression crossed Derek’s face. “I hope it’s not, too. I’m going to grab a bite. You should try and have something to eat.”
He left quickly, and Evelyn couldn’t help but wonder what had gotten into him. She’d thought he wanted to talk more.
She shrugged it off. She couldn’t worry about it right now. She opened Jennifer’s file and starting skimming through the various notes made over the course of her pregnancy. Her heart sank as it became apparent that she wasn’t the only one who was thinking intrauterine growth restriction.
Damn.
* * *
Derek didn’t head to Sally’s. He didn’t feel hungry all of a sudden. Instead he headed down the street to daycare.
It wasn’t a bustling daycare center. His daughter was currently the only child in town who needed continuous daycare service during the summer. It was convenient, as she was still a bit sick, and he knew if they’d been in a big city he would have had to arrange for another sitter or taken time off.
Of course if they had decided to move to Chicago he would have had his mother there to help—plus most likely he wouldn’t have been the only doctor in his practice as he wouldn’t have been able to afford to buy a solo practice.
But he loved Wolf’s Harbor.
Vivian had been from here, and though she’d had parents elsewhere in Alaska she’d been on her own, and they’d made a vow to raise their children here.
Perhaps if another doctor would come and permanently settle here they could trade off, but that was unlikely.
No one ever stayed.
He opened the door to the daycare center, making the bell jingle as he walked in, and slipped off his shoes. Mo was sitting on the couch. Her round gray-green eyes that were so like his lit up when she saw him. His heart melted. He loved her. She was his world. The only thing besides his practice that kept him going.
“Daddy!”
Derek went over and sat down next to her. “How are you feeling?” he asked.
“Better,” Mo chirped.
“Monica’s fever has broken this morning,” said Edna the daycare owner as she came into the room.
“Good.”
“You off for the day, Dr. Taylor, or is this just a visit?” Edna asked.
“Just a visit.”
Edna smiled and left the room.
Mo curled up next to him, holding her blanket, completely fascinated by the crazy cartoon that wa
s on the television.
Derek ran his hand over her forehead. It was clammy, but no sign of a fever.
“I’m fine, Daddy,” Mo said, pushing his hand away, annoyed that he was interrupting her show.
So like Vivian.
Everything about Mo reminded him of his late wife. Her personality. Her attitude. Vivian would have loved everything about Mo, and instead of Edna it would have been Vivian taking care of her.
Edna had been helping him take care of Mo since she was born, and she was a warm, loving caretaker, but it wasn’t the same as having a mother. And in that Derek thought he was failing Mo. That he wasn’t enough for her.
He sat next to her and mindlessly watched the cartoon, laughing with her at the parts she thought were funny and wishing he could give her more. But he wasn’t sure that he could ever put his heart in jeopardy like that again.
He was frozen.
It had been five years since Vivian died, and he was lonely, but remembering the agony he’d gone through losing her, he knew he could never do that again. Mo didn’t remember her mother. Didn’t know the pain of losing her. He never wanted to put her through that. He could handle the pain, but he never wanted Mo to feel it.
Mo drifted off to sleep and Derek slid off the couch, helping her lie down and then covering her with the blanket that Vivian had made for her when she was pregnant. The blanket was ratty and worn, but Mo wouldn’t be parted with it and Derek wouldn’t even try.
Edna came into the room and Derek motioned to her that Mo was sleeping. He waved goodbye to her from the door, put on his shoes and strode out into the drizzly afternoon.
He stopped by Sally’s and grabbed a sandwich, and then grabbed one for Evelyn. He didn’t know what she’d like, so he stuck with egg salad just in case she was vegetarian.
He’d been impressed with Evelyn’s performance in helping Christina and her baby. Maybe if she’d been here when Mo was born Vivian would still be here.
He shook his head, because he couldn’t dwell on the what-ifs. Those what-ifs that haunted him nightly.
He rounded the corner to the clinic, and his heart skipped a beat when he saw the town ambulance waiting outside.
He ran into the clinic and saw Nancy looking pale.